Individual
CHANHI PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2602 BUFORD RD, NORTH CHESTERFIELD, VA 23235-3422
(804) 272-8806
(804) 272-2909
Mailing address
2602 BUFORD RD, NORTH CHESTERFIELD, VA 23235-3422
(804) 272-8806
(804) 272-2909
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101231753
VA
2085R0202X
Diagnostic Radiology Physician
ME66655
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25527
BC BS OF FLORIDA
FL
05
—
269912500
—
FL
Enumeration date
11/23/2005
Last updated
03/17/2018
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